Pregnancy outcomes among native and foreign-born women in Taiwan: maternal health utilization.
BACKGROUND
As immigrant populations increase rapidly around the world and with most immigrant women being of childbearing age, their use of pregnancy-related healthcare has become an important health issue. However, there has been only limited research available on maternal health use by foreign immigrants in Asia. This study aims to compare inpatient use for pregnancy complications and type of delivery among foreign and native-born women of different socioeconomic status in Taiwan.


METHODS
Using the 2001 National Health Insurance (NHI) database, 232,828 deliveries were identified, of which 222,852 were to native-born mothers and 9,976 were to foreign-born mothers. Univariate and multivariate logistic regression models were used to determine the likelihood of using inpatient services for any pregnancy complication and for cesarean section.


RESULTS
Our results indicate that after adjusting for other factors, foreign-born women were less likely than native-born women to use inpatient services for complicated pregnancies across all socioeconomic status (SES) levels. On the other hand, a pattern emerged among the higher SES groups showing a similar likelihood of cesarean section when foreign-born and native-born mothers were compared. This was not the case for the lower SES groups, however, where native-born mothers were significantly more likely to undergo a cesarean section than foreign-born mothers.


CONCLUSIONS
Foreign-born mothers tended to use fewer inpatient services for complicated pregnancies than native-born mothers and were less likely to undergo cesarean section. As immigrants increase across the world as a result of globalization and with half of them being female, pregnancy-related health service use among this group needs our attention.
Chou
Yun-An
YA
Institute of Public Health, School of Medicine, School of Medicine, National Yang Ming University, Taiwan, ROC.
Chou
Yiing-Jenq
YJ
Lee
Cheng-Hua
CH
Huang
Nicole
N
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D016208:Databases, Factual; D004641:Emigration and Immigration; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000191:economics / Q000706:statistics & numerical data*; D009313:National Health Programs; D007744:Obstetric Labor Complications / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000628:therapy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012959:Socioeconomic Factors; D013624:Taiwan / Q000208:ethnology; D055815:Young Adult